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Additional sections cover campus correction details, federal and state withholding allowances based on IRS W-4 guidance, employee certification, representative authorization, designee information, and the oath of allegiance or declaration of permission to work for new employees.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/csu-student-payroll-action-request-form-457/302966/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/csu-student-payroll-action-request-form-457/302966.png","ImageObject",442,249,{"name":42,"@type":43},"Jiven","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-02","2026-09-19",true,{"@type":52,"interactionType":53,"userInteractionCount":26},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What payroll actions can be requested on this form?","Question",{"text":62,"@type":63},"The form includes selectable options for new employee information, withholding changes, address changes, name changes, birthdate changes, and Social Security number changes. Appropriate sections must be completed for each selected action.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What guidance must be followed before completing the withholding section?",{"text":67,"@type":63},"Before completing Section G, the employee must read IRS Form W-4 and the applicable state tax form. For California, the form references CA state tax Form DE-4 instructions.",{"name":69,"@type":60,"acceptedAnswer":70},"What does the employee certification require?",{"text":71,"@type":63},"The employee certifies that provided information is true and that they have read the applicable IRS and state forms. The certification also includes statements about the accuracy of withholding exemptions and allowances and authorization related to over collection refunds.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},302966,1790945640,{"code":4,"msg":81,"data":82},"success",[83,88,93,98,103,108,112,117,122],{"id":84,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},11,"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":110,"slug":111},17,40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":81,"data":127},{"doc_id":78,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":109,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":135,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":30},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399","STATE OF CALIFORNIA-CONTROLLER’S OFFICESTD. 457 (REV. 12/2020)  \nCSU STUDENT PAYROLL ACTION REQUEST  \nOFFICE USE ONLY  \n\n| A | 01 AGENCY | 02 UNIT | 03 CLASS | 04 SERIAL |\n| --- | --- | --- | --- | --- |\n\nCHECK ALL APPROPRIATE BOXES AND COMPLETE LISTED SECTIONS  \n\n| B | ✔\u003Cbr>| A98 NEW EMPLOYEE INFORMATION (C THRU H, J, K) | | E03 WITHHOLDING CHANGE (C, G, H) | | E04 ADDRESS CHANGE (C, E, H) | | E05 NAME CHANGE (C, D, H)(ATTACH SUBSTANTIATION) NAME WAS | | E07 BIRTHDATE (C, E, H) | | 105 SSA NUMBER CHANGE (C, H)(ATTACH SUBSTANTIATION)\u003Cbr>NO. WAS |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n\nCAMPUS USE ONLY DESIGNEE CORRECTION (C, H, J)  \n\n| C | 01 SOCIAL SECURITY NUMBER | 02 EMPLOYEE LAST NAME | 03 FIRST NAME AND MIDDLE INITIAL |\n| --- | --- | --- | --- |\n\n\n| D | FORMER NAME (Last, First and Middle Initial) |\n| --- | --- |\n\n\n| E | 01 EMPLOYEE ADDRESS (Street, P.O. Box, or Rural Route) | 02 CITY | STATE | 03 ZIP CODE |\n| --- | --- | --- | --- | --- |\n\n\n| F | BIRTHDATE |  |  |\n| --- | --- | --- | --- |\n|  | Mo. | Day | Yr. |\n\nWITHHOLDING CERTIFICATE ***IMPORTANT*** Before completing Section G, you must read IRS Form W-4 and the applicable state tax form. (For California, use CA state tax Form DE-4 instructions)  \n\n| G | I. FEDERAL WITHHOLDING\u003Cbr>If no tax should be withheld, complete Box 3 and Parts III and IV.\u003Cbr>01  NONRESIDENT ALIEN\u003Cbr>04 HIGHER WITHHOLDING\u003Cbr>02 MARITAL STATUS (Check One) (MUST BE Y OR N. See reverse employee copy.) FOR TAX PURPOSES ONLY 05 CLAIM DEPENDENTS\u003Cbr>AMOUNT MUST BE A WHOLE NUMBER\u003Cbr> SINGLE 06 OTHER INCOME\u003Cbr>NOT FROM JOBS\u003Cbr> MARRIED 07 DEDUCTIONS\u003Cbr> HEAD OF HOUSEHOLD\u003Cbr>03 EXEMPT FROM FEDERAL WITHHOLDING-Write/type EXEMPT in box 03 if you are eligible to claim exemption from Federal withholding. 03 (See Reverse)\u003Cbr>|  |  |  | III. EXEMPTION FROM WITHHOLDING-Write EXEMPT in box 11 if you are eligible to claim exemption from withholding. No Federal or State income tax will be withheld from your wages. DO NOT COMPLETE PARTS I or II. (See General Information-Reverse.)\u003Cbr>11 I claim exemption from withholding because of no tax liability: Last year I did not owe any income tax\u003Cbr>and had a right to a full refund ofALL income tax withheld, AND this year I do not expect to owe any income tax and expect to have a right to a full refund ofALL income tax withheld.\u003Cbr>If you are not having income tax withheld this year but expect to have a tax liability next year, you must file a withholding allowance claim by December 1st of this year.\u003Cbr>This exemption will automatically expire February 15th of next year unless you file a withholding allowance claim by December 1st of next year. |\n| --- | --- | --- | --- | --- | --- |\n|  | II. STATE ALLOWANCES\u003Cbr>If no tax should be withheld, complete Part III and IV only. |  |  |  |  |\n|  | 08 MARITAL STATUS (Check one) FOR TAX PURPOSES ONLY\u003Cbr>SINGLE OR MARRIED (WITH TWO OR MORE INCOMES)\u003Cbr>MARRIED (ONE\u003Cbr>INCOME)\u003Cbr> HEAD OF HOUSEHOLD\u003Cbr>| 0910 | | REGULAR ALLOWANCES TOTAL YOU ARE CLAIMING\u003Cbr>ADDITIONAL ALLOWANCES TOTAL YOU ARE CLAIMING |  |\n|  |  |  |  |  | IV. NONTAXABLE WAGES-Complete box 12 if wages you will receive are not subject to income tax withholding. (See General Information-Reverse)\u003Cbr>12  I claim that the wages I will be receiving from the State are either 1) MINISTER OF A CHURCH wages, 2) NONRESIDENT ALIEN wages, or 3) DECEASED EMPLOYEE wages. Indicate Reason: |\n\nEMPLOYEE CERTIFICATION  \n\n| H | I certify the above information is true and that I have read IRS Form W-4 or W-4 and applicable state form. Under the penalties of perjury, I certify that the amount of of withholding exemptions and allowances claimed does not exceed the amount to which I am entitled. If claiming exemption from withholding, I certify I incurred no tax liability for last year and I anticipate I will incur no liability this year. I authorize my employer via the State Controller’s Office to refund any over collection of current/prior year Social Se","cbCaibFBzX4iTCVK","https://ap.wps.com/l/cbCaibFBzX4iTCVK","pdf",859246,8,"English","# Action selections\n# Designated corrections\n# Withholding certificate\n## Federal withholding\n## State allowances and nontaxable wages\n# Employee certification and signatures\n## CSU representative authorization\n## Designee for state warrants\n# Oath of allegiance / permission to work","[{\"question\":\"What payroll actions can be requested on this form?\",\"answer\":\"The form includes selectable options for new employee information, withholding changes, address changes, name changes, birthdate changes, and Social Security number changes. Appropriate sections must be completed for each selected action.\"},{\"question\":\"What guidance must be followed before completing the withholding section?\",\"answer\":\"Before completing Section G, the employee must read IRS Form W-4 and the applicable state tax form. For California, the form references CA state tax Form DE-4 instructions.\"},{\"question\":\"What does the employee certification require?\",\"answer\":\"The employee certifies that provided information is true and that they have read the applicable IRS and state forms. The certification also includes statements about the accuracy of withholding exemptions and allowances and authorization related to over collection refunds.\"}]","CSU Student Payroll Action Request - Form 457 | PDF",1789799064]